Claim Settlement Ratio of Edelweiss Tokio

Edelweiss Tokio is a renowned life insurance company that gives financial cover to you and your family members in case of any foreseen circumstances. But do you know the claim settlement ratio of Edelweiss Tokio? If not, let us explain what it is and why it is important. A claim settlement ratio lets you know the percentage of claims which Edelweiss Tokio has paid in a financial year. In simple words, it is the total insurance number of claims settled by an insurer compared to the total number of claims received.

For instance, if the death claim settlement ratio of Edelweiss Tokio is 90%, it implies that the insurer has settled 90 death insurance claims out of every 100 insurance claims received in that year. This way, the death claim settlement ratio is 90% for Edelweiss Tokio and the remaining 10% are rejected by the insurer due to any complication like whether the claim requires more investigation or there is a lack of documentation.

The higher the claim settlement ratio, the more confidence you will have in Edelweiss Tokio as it reflects the commitment of the insurer. The CSR is calculated using the following formula:

Claim settlement ratio = (settled claims/received claims) x 100

In the below table, you can find the claim settlement ratio of Edelweiss Tokio for different fiscal years.

Financial Year Claim Settlement Ratio of Edelweiss Tokio (in percentage)
2016-17 93.29%
2017-18 95.24%
2018-19 95.82%
2019-20 83.44%

The figures mentioned above are published annually by the Insurance Regulatory and Development Authority of India (IRDAI) in its annual report.

What is the Death Claim Settlement for Edelweiss Tokio in 2018-19 (for both individual and group insurance)

As per the IRDAI annual report 2018-19, the following are the death claims settled by Edelweiss Tokyo during the particular financial year.

Type of Policy Total Claims Paid Claims Rejected Claims Pending Claims Repudiated Claims Unclaimed Claims
Individual 239 229 0 0 10 0
Group 1,021 1,011 0 0 10 10

Edelweiss Tokio Life Solvency Ratio in 2018-19

With the company solvency ratio, you can find out the insurance company’s financial situation in the previous financial year. The IRDAI maintains the record of the solvency ratio of all the companies in India. This is quite similar to the claim settlement ratio of Edelweiss Tokio, as with the solvency ratio, you can find whether your insurer is financially stable or not to make your claim payment. Check out this table below and know the Edelweiss Tokio Solvency Ratio for the financial year 2018-19.

Date Quarterly Solvency Ratio
30.06.2018 2.22
30.09.2018 2.45
31.12.2018 2.37
31.03.2019 2.29

Who is Eligible to Receive a Claim from Edelweiss Tokio Life?

The claim will be paid to any of the following beneficiaries –

  1. Nominee
  2. Assignee in case of assignment
  3. Appointee if the nominee is a minor
  4. The proposer if the policy is not on own life
  5. Life Assured himself/herself – in the case of claims made for disability, critical illness, and hospital cash benefits.

Edelweiss Tokio Life pays the claim amount through cheque or NEFT as per user convenience.

Edelweiss Tokio Claim Settlement Process

Now, you know what is the claim settlement ratio of Edelweiss Tokio, so let’s find out how it processes a policyholder claim. Follow the below steps:-

  1. Provide a written intimation to Edelweiss Tokio Life
  2. When the insurer gets the intimation, it will communicate the documents which are required for the claim processing
  3. You need to submit all the requisite documents
  4. Edelweiss Tokio Life will process your claim after receiving and verifying all the documents

Note:- All genuine and bonafide claims are settled within 24 hours of the submission of all the required documents & information. And if the insurer delays the claim payment, it will pay interest at 10% per annum for all policies with a Sum Assured of up to INR 5 Crores. All claims including the death claim are intimated via the following channels: Online, Customer Care Center (Dial the Toll-Free Number 1-800-2121-212), or at the Edelweiss Tokio nearest branch. To know more about claim notification, you can visit the official website of Edelweiss Tokio.

When Edelweiss Tokio Life Claim Gets Rejected?

The company will reject a claim request in the following cases:-

  1. If the policy is not in force:- When the policy is not running, and you make a claim request, the company will deny it at the very moment. And you will get the knowledge of this via a message or mail on your registered mobile or email id.
  2. If an exclusion condition applies:- When the policyholder requests for a claim and the condition is not covered in the policy, the insurance company will reject the claim. So read all the policy documents carefully before purchasing insurance from Edelweiss Tokio Life.
  3. If the claim is found to be fraudulent:- During the verification process of your claim request, if Edelweiss Tokio finds any fraudulent action in the reports, or if the documents are forged, the company will reject your claim on the grounds of fraudulent claims.

These rejected claims will be counted and excluded from the claim settlement ratio of Edelweiss Tokio.

List of Micro Insurance Products of Edelweiss Tokio Life at 31.03.2019

The following are the policies which are introduced by Edelweiss Tokio Life:-

Edelweiss Tokio Life Raksha Kavach – This is a non-linked, non-participating micro term assurance plan that will give death benefit in case of death of the life assured death, the sum assured will be paid to the beneficiary. For a Single Pay policy surrender under this policy, the following values are payable:

Policy Term Surrender Value
1 60%
2 45%
3 30%
4 15%
5 0%

And you can also avail of tax benefits under Section 80C and Section 10 (10D) of the Income Tax Act, 1961. These tax benefits are subject to change as per the prevailing tax laws.

Edelweiss Tokio Life Dhan Nivesh Bima Yojana –  A non-linked, non-participating endowment plan for the rural customers. You will get a lump sum death benefit in this plan which comes in two option:-

  1. Option 1:- Sum Assured is 5X the single premium
  2. Option 2:- Sum Assured is 10X the single premium

At the end of the policy term, the policyholder will get a guaranteed maturity benefit that is payable in a lump sum to the life assured. Check out the table to know in detail.

Age of the Life Assured Option 1 Option 2
18 – 35 2.00 x Single Premium 1.86 x Single Premium
36 – 40 1.90 x Single Premium 1.66 x Single Premium
41 – 45 1.80 x Single Premium 1.43 x Single Premium

 

If you make a surrender request in the first policy year, the surrender application will be accepted, but the surrender value will be payable only at the end of the first policy year. The Surrender Value from the 2nd year onwards is as follows:-

Policy Term Surrender Value
1 and 2 46%
3 50%
4 55%
5 60%
6 65%
7 71%
8 77%
9 84%
10 92%

 

Edelweiss Tokio Life Jan Suraksha – A group term micro-insurance plan which provides a cover against death. Under this plan, the Master Policyholder can help its members secure their family members financially in the case of an unfortunate demise of the member. The group plan offers two types of coverage –

  1. Level Sum Assured: The payable Sum Assured remain level throughout the coverage term
  2. Decreasing Sum Assured: The payable Sum Assured decreases during the coverage term as per the policy Benefit Schedule

In case of the death of the Insured Member, the Sum Assured will be payable as per the Benefit Schedule. The surrender benefit is valid from the policy first year. You can take this Edelweiss Tokio plan on a Single or Joint Life basis.

 

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